Parental Knowledge and Attitude Regarding E-Cigarette Use in Saudi Arabia and the Effect of Parental Smoking: A Cross-Sectional Study.

INTRODUCTION: E-cigarette use has been on the rise among children and adolescents. This study aimed to assess the knowledge and attitudes of the health hazards and laws regarding e-cigarette use among parents in Saudi Arabia. In addition, we evaluated the effect of parental smoking on parent's knowledge. METHODS: This study was conducted with parents of children below 18 years of age in Jeddah, Saudi Arabia. Jeddah was divided into four areas (north, south, east, and west) and in each area, the largest shopping mall was selected. Data were gathered using a self-administered questionnaire. RESULTS: Out of 1386 parents, 61.7% were smokers, 13.3% reported that their children used e-cigarettes, and 73.6% did not discuss e-cigarette use with their children. In total, 77.3% of parents thought it was important to be educated about e-cigarette use. However, their ability to discuss e-cigarette use with their children was 13.9% lower than their ability to discuss regular cigarette smoking with their children. Parents who were smokers were more accepting of their children using e-cigarettes (P<0.0001). Mothers who smoked were more accepting than fathers of their children using e-cigarettes (P<0.0001). CONCLUSION: Parents reported a lack of knowledge and attitudes regarding e-cigarette use. Parental smoking, especially among mothers, was statistically significantly related to their e-cigarette use knowledge and attitudes. Parents agreed that it was important to educate parents regarding e-cigarette use.

Contemporary public image of the nursing profession in Saudi Arabia.

BACKGROUND: In the Kingdom of Saudi Arabia, the nursing profession faces significant challenges including; failure to recruit high school students into nursing education, poor nursing identity, and lack of awareness about the nursing profession. The level of community awareness and public image of the nursing profession are critical to recruit and retain students into nursing education, and to improve nurses' sense of identity. AIM: To explore the level of community awareness and public image of the nursing profession in Saudi Arabia. METHODS: We conducted a cross-sectional study with a convenient sample of 502 adults including106 males and 396 females, their mean age was 22.93 ± 6.76 years. Data collected included; socio-cultural data, gender preference in getting nursing care, awareness, and perceived socio-cultural barriers to pursue a nursing career. Data were analyzed using SPSS version 21.0. RESULTS: Only 32.5% preferred to get nursing care by Saudis. The nursing profession was not viewed as a respected job as 71.5% of participants would be ashamed of having a nurse in their families. The study revealed a low median knowledge score (50.0, IQR: 50.0-66.7)). The study highlighted a number of socio-cultural barriers to pursue a nursing career including; the gender-mixed working environment (35.9%), delayed marriage of female nurses (20.3%), and the negative effect of nursing profession on social life (64.5%). CONCLUSIONS: Half of the sample had a knowledge score below 50.0 out of 100. This level of poor awareness, in addition to socio-cultural perceived barriers are the main factors contributing to the negative public image of the nursing profession in Saudi Arabia. Understanding these factors could contribute to implementing focused intervention to improve the negative stereotype of the nursing profession among Saudis.

Molecular Screening of VAX1 Gene Polymorphisms Uncovered the Genetic Heterogeneity of Nonsyndromic Orofacial Cleft Among Saudi Arabian Patients.

OBJECTIVE: Nonsyndromic orofacial cleft (NSOFC) including cleft lip with or without cleft palate (CL±P) and cleft palate (CP) are multifactorial developmental disorders with both genetic and environmental etiological factors. In this study we investigated the association between CL±P and CP, and two polymorphisms previously determined using genome-wide association studies, as well as the association between consanguinity and CL±P and CP. METHODS: DNA was extracted from saliva specimens from 171 triads consisting of affected individuals and their parents, as well as 189 control triads (matched for age, gender, and location) that were recruited from 11 referral hospitals in Saudi Arabia. Two polymorphisms, rs4752028 and rs7078160, located in the VAX1 gene were genotyped using real-time polymerase chain reaction. A transmission disequilibrium test was carried out using the Family-Based Association Test and PLINK (genetic tool-set) to measure the parent-of-origin effect. RESULTS: Significant differences were found between affected individuals and the control group. In the case of the rs4752028 risk allele in cleft, the phenotypes were: CL±P (fathers: odds ratio [OR] 2.16 [95% CI 1.38-3.4]; mothers: OR 2.39 [95% CI 1.53-3.71]; and infants: OR 2.77 [95% CI 1.77-4.34]) and CP (fathers: OR 2.24 [95% CI 1.15-4.36] and infants: OR 2.43 [95% CI 1.25-4.7]). For CL±P and the rs7078160 risk allele, the phenotypes were: (fathers: OR 1.7 [95% CI 1.05-2.86]; mothers: OR 2.43 [95% CI 1.49-3.97]; and infants: OR 2.34 [95% CI 1.44-3.81]). In terms of consanguinity, we found significant association between consanguinity and the rs4752028 polymorphism minor allele among CL±P compared with controls (p = 0.001). CONCLUSION: This is the first study to find a relationship between these two loci on 10q25 (rs4752028 and rs7078160) and NSOFC in a population with high levels of consanguinity.

The effect of personality traits on undergraduate dental students' performance in multiple mini interviews.

BACKGROUND: Multiple mini interviews (MMI) is a structured student selection method where applicants rotate around a series of stations that do not require previously learned knowledge. The Big Five Inventory (BFI) is a tool often used to measure personality traits commonly used in applicant selection. OBJECTIVE: The aim of the current study was to assess the effect of personality traits using the BFI on undergraduate dental students' performance in MMI. METHODS: This research was conducted at The Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. All undergraduates applying to the dental program at King Abdulaziz University, Faculty of Dentistry (KAUFD) in two academic years [(2014-2015) and (2015-2016)] undertook the MMI held at KAUFD and completed the BFI inventory with a total number of 350 students. The MMI consisted of five stations while the BFI contained forty-four items. Data were analysed by SPSS version 20, using independent-samples t-test, Mann-Whitney U test, Spearman's rho correlation coefficient and Chi-square test. RESULTS: female students scored higher than their male counterparts but scores were only significant in the empathy station (p<0.001) in the first year, and in both empathetic skills and team work abilities (p<0.05) in the second. BFI results indicate that male students scored higher on agreeableness (p<0.003) and lower on neuroticism (p<0.001) in the first year while female students scored higher on agreeableness and conscientiousness (p<0.001) in the second year. Students of private schools had higher total MMI scores compared to those of public schools (p<0.05). CONCLUSION: MMI combined with the Big Five Inventory can be a useful tool in the admission process.

Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis.

BACKGROUND: Studies have found a consistent positive association between maternal smoking and non-syndromic orofacial clefts (NSOFC). However, no comprehensive assessment of the association between NSOFC and passive smoking has been undertaken. This systematic review and meta-analysis explores the relationship between maternal passive smoking and NSOFC, and compares the associations between passive and active smoking. METHODS AND FINDINGS: Search strategy, inclusion / exclusion criteria, and data extraction from studies reporting maternal passive smoking and NSOFC was implemented without language restrictions. Risks of bias in the identified studies were assessed and this information was used in sensitivity analyses to explain heterogeneity. Meta-analysis and meta-regression of the extracted data were performed. Egger's test was used to test for small study effects. Fourteen eligible articles were identified. Maternal passive smoking exposure was associated with a twofold increase in risk of NSOFC (odds ratio: 2.11, 95% confidence interval: 1.54-2.89); this was apparent for both cleft lip with and without palate (OR: 2.05, 95% CI: 1.27-3.3) and cleft palate (OR: 2.11, 95% CI: 1.23-3.62). There was substantial heterogeneity between studies. In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk. CONCLUSION: Overall, maternal passive smoking exposure results in a 1.5 fold increase in risk of NSOFC, similar to the magnitude of risk reported for active smoking, but there is marked heterogeneity between studies. This heterogeneity is not explained by differences in the distribution of cleft types, adjustment for covariates, broad geographic region, or study bias/quality. This thorough meta-analysis provides further evidence to minimize exposure to environmental tobacco smoke in policy making fora and in health promotion initiatives.

Parental consanguinity and nonsyndromic orofacial clefts in children: a systematic review and meta-analyses.

OBJECTIVE: To assess whether individuals born to consanguineous parents had a higher frequency of nonsyndromic orofacial clefts compared with those with no parental consanguinity. DESIGN: A prespecified plan for a search strategy, inclusion/exclusion criteria, and data extraction from studies reporting consanguinity in relation to nonsyndromic orofacial clefts (NSOFC) was carried out. Papers reporting observational studies with control populations were included, without language restrictions, and these reports were assessed for quality. Sensitivity analyses using subgroups, homogeneity evaluation, and assessment of publication bias were carried out, and meta-analyses of extracted data were performed. RESULTS: Sixteen studies fulfilled the selection criteria and were included in the meta-analyses. There were statistically significant relationships between consanguinity and NSOFC for all 16 studies combined (P = .0003), with odds ratio (OR) = 1.83 and 95% confidence interval (CI) = (1.31, 2.54); 10 case-control studies (P = .006), with OR = 2.06 and 95% CI = (1.23, 3.46); six cross-sectional studies (P = .03), with OR = 1.34 and 95% CI = (1.02, 1.76); first cousins consanguineous marriages (P = .04), with OR = 1.40 and 95% CI = (1.01, 1.93); cleft palate alone (P = .01), with OR = 1.89 and 95% CI = (1.14, 3.13); and cleft lip with or without cleft palate cases (P = .002), with OR = 1.56 and 95% CI = (1.18, 2.07). CONCLUSION: Although there was a high level of study heterogeneity, the evidence is consistent in suggesting that consanguinity is a risk factor for NSOFC, with an overall OR of 1.83 (95% CI, 1.31 to 2.54), implying that there was almost twice the risk of a child with NSOFC being born if there was parental consanguinity.

The probability distribution of attendance to hospital emergency units for school students in Alexandria.

The present work is a retrospective study designed to examine the assumption that emergency arrivals at the Sporting Students' Hospital in Alexandria follow a Poisson distribution. Data about all arrivals at the emergency room (ER) for the year, 2000 (43076 arrivals) was extracted from the records of the emergency department and classified by age, sex, school, reason for visit, date and time of visit. Data analysis revealed that 12.9% of the total arrivals indicated hospital admission either to the inpatient units (12.5%) or the ICU (0.4%). Goodness of fit test showed that admissions to the ICU fit the Poisson distribution but those admitted to the inpatient units did not follow the assumed distribution. However the latter group did not fit exactly the normal distribution which indicated that deviance from the Poisson is due to the large mean non-elective admissions (14.74% per day). Hence the Poisson assumption is not excluded as the inpatient emergency admissions are still randomly distributed and independent. Univariate and multivariate Poisson regression of the daily emergency admissions gave another clue to the goodness of fit of emergency admissions to the Poisson process. Regression analysis showed significantly higher loge number of emergency admissions among the age group 12 or more, male students, medical conditions in contrast to injuries, governmental schools, and at 04:00-11:59 pm in contrast to midnight to 07:59 am. Results of the present study indicated the random nature of demand for emergency admission which affects use of bed stock. A prospective study of these admissions on daily basis is needed.

Time-series analysis of under five mortality in Alexandria.

The aim of this study is to analyze levels, trend and seasonal patterns of under-5 mortality in Alexandria. In order to fulfill this aim, a retrospective study is conducted to collect recorded data about under-5 deaths and live births from 1996 to 2001 from Health Information Center and CAPMAS in Alexandria. Causes of death are categorized using the ICD-10. Several trend equations were tried to select the best fit trend equation. Seasonality is tested using the 12-month moving average method. The predicted value for under-5 mortality rates for the year 2002 is calculated using the best-fit trend equation and the seasonal index and compared to the actual levels to test the validity of the prediction models. The study revealed a significant downward trend of U5MR PNMR and CMR while the NMR does not show significant decrease over the study period. The peak seasonal index of U5MR is in December followed by summer months, those of NMR and CMR are in summer and PNMR is mainly in winter. Maximum index of U5MR due to ARI is in winter while rates related to congenital malformations are in autumn while deaths due to perinatal conditions are mainly in May and June, and external causes of injury are mainly in summer. Though the picture is promising special emphasis is still needed for ARI, congenital anomalies and perinatal conditions.

Geographic information systems (GIS) analysis of under five mortality in Alexandria.

The aim of this study is to analyze under five mortality in Alexandria using GIS. A retrospective study is conducted to collect recorded data about under-5 deaths and live births from 1996 to 2001 from Health Information Center and CAPMAS in Alexandria. Data used include sociodemographic and environmental conditions in Alexandria sub-districts digitized maps of Alexandria districts and sub-districts (scale 1 50 0000). The spatial analysis of the geographical database revealed that there is regional variations of U5MR. GIS overlay analysis indicates that there is no association between low sociodemographic and environmental indicators and deaths caused by perinatal conditions and congenital malformations. The cause of death most associated with low sociodemographic and environmental indicators are found to be ARI and external causes of mortality. This is quietly evident in Amria and Borg Al Arab sub-districts.